| NPI | 1972674935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: PR 276) |
| Additional Taxonomies | 163WF0300X Registered Nurse, Flight (Licence: PR 7242) |
| 171100000X Acupuncturist (Licence: PR 7242) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |